Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force

Eur J Pain. 2019 Apr;23(4):641-651. doi: 10.1002/ejp.1362. Epub 2019 Feb 18.


Background: Complex regional pain syndrome is a painful and disabling post-traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS.

Methods: The European Pain Federation established a pan-European task force of experts in CRPS who followed a four-stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must-do) statements.

Results: We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multidisciplinary care, 1 in assessment, 3 for care pathways, 1 in information and education, 4 in pain management, 3 in physical rehabilitation and 2 on distress management. The standards are presented and summarized, and their generation and consequences were discussed. Also presented are domains of practice for which no agreement on a standard could be reached. Areas of research needed to improve the validity and uptake of these standards are discussed.

Conclusion: The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures.

Significance: This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / psychology
  • Anxiety / therapy
  • Complex Regional Pain Syndromes / diagnosis*
  • Complex Regional Pain Syndromes / psychology
  • Complex Regional Pain Syndromes / rehabilitation
  • Complex Regional Pain Syndromes / therapy
  • Depression / diagnosis
  • Depression / psychology
  • Depression / therapy
  • Europe
  • Humans
  • Mass Screening
  • Pain Management*
  • Patient Education as Topic
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy